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Lot
PERMIT - APPLICATION AND RECORD
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Address
Type of Permit:
Block
Nature of Work
PLUMBING CONTRACTOR. .
Bu. San. Sewer - Curb to Bu.
Bu. St. Sewer Curb to Bu.
Main to Curb:
Main to Curb
Sewer Fees
Water Service
Bath Tub I Floor Drain - Urinal
Wash Basin ~ Garbage Disp. - S. Sink
Water Closet~ Dish Washer - Catch Basin -
Kit. Sink I Laundry Mach.- S. Pump
Water Heater_Water Soft. - B & S Waste -
Shower Bath- Bubbler Conductors -
Plumbing Fees Total Fees
HEATING CONTRACTOR
Fuel: Gas D Oil D Elec. D Solar D Solid D
Conditioning Forced Air D H.W. D Elec. Base D Steam D
System Gravity D Supplementary D Air Condo D
Chimney: "A" D "B" D Direct Vent D Can. Burner D
Calculated Heat Loss System BTU Rating
ELECTRIC CONTRACTOR
Electric Service: New
Description-Type
Fixtures -
Appliances
Changes
Temp.
Switches
Volts
Recep's
Signs
CITY OF OSHKOSH
- Owner Ar1- ~lA/~/i
Subdivision
Sign D
, tl
Amps
Circ's
N~
6901
Zoning
Insp.
Id. No.
Flood Plain
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Wrecking D
Permit Date
Occupancy Permit
BUILDING Use
General Cant.
Roof
Siding
Type of Construction
Foundation
Size: - feet wide X
feet long
Square feet
Height:
Stories and Basement
above Grade
Width of Lot
No. of Rooms
l
Mason
Carpenter
Architect
1- ----.It.
----.It.
Inspections -
Footing
Foundation
Electric Service
R.I.
.3
il;:
Q Final
Estimated Cost /.2.. ðV -- Fees Paid V / () /' t??ì Date
TO THE BUILDING INSPECTOR: In accordance with Section 7-18 of the Municipal Code of the City of Oshkosh, it is agreed that if work
shall be discontinued for a period of 30 days at any time for any cause after excavation work is commenced, a solid barrier, wall, orwire
fence not less than five feet in height shall be erected all around such excavation. Such barrier, wall orwire fence wili remain in position
untii removal is approved by the Building Inspector.
ï
the performance of this work the undersigned agrees to abide by and do work pursuant to all statutes,
ordinances, codes, and rules governing the described construction.
(Signed)
Address
By ¿X .1\'"'---~ ~Ilwvl~ ::1 ~ ")
(A",hod,,' Sigo"",e) _I D I J
Address '-{:3 J :5 -Vv, £'..v-"y'A<.>i' <J5~--=-
Agent